Lifestyle Modification: Another approach to prevention By Gary C. Chamness, PhD Contributing Faculty Editor Healthy women have been reluctant to consider long-term drug therapy, even though they might be at increased risk of breast cancer, so there has been much interest in the idea of lifestyle factors as risk modifiers. At General Session 5 on Saturday morning, Rowan Chlebowski, MD, PHD, from LABioMed, presented mature results from the Women’s International Nutrition Study (WINS) evaluating dietary fat reduction and breast cancer outcome. Preclinical and observational studies first suggested that dietary fat might be related to breast cancer outcome almost 25 years ago. The WINS study, initiated in 1994, is a phase 3 clinical trial evaluating the efficacy of reduced dietary fat on relapse-free survival in early stage breast cancer patients receiving standard therapy. Interim analyses were presented at ASCO 2005, based on the last protocol-specific review in October 2003, while the dietary intervention was ongoing. Dr. Chlebowski presented new data on clinical outcomes available through December 10, 2006, from clinical follow-up and national death registry. Patients in the dietary intervention arm of the study reduced their intake of fat as a percent of total calories consumed from 29% to about 21%. The reduction in fat intake was across all categories of fat (saturated, polyunsaturated, monounsaturated). Patients in both treatment arms were evenly matched for age, tumor size, nodal status, histologic type, ER/PR status, and treatment type, with the exception that more patients in the intervention arm received mastectomies. At a median follow-up of 5/8 years, patients in the dietary intervention arm showed better relapse-free survival (hazard ration [HR]=0.79) and OVERALLl survival (HR=.078) compared with the control arm. Of special note in this study, advantages in both outcomes were associated with negative hormone receptor status. For relapse-free survival, the HR for intervention vs control patients was 0.9 for ER+/PR+ patients compared with 0.47 for ER-/PR- patients. A similar picture was seen for disease-free survival and OVERALL survival. This preferential benefit in hormone receptor-negative patients is especially interesting, since this is the specific group that might not benefit from SERM or AI Prevention strategies. Unfortunately, an interruption in funding support during the clinical trial affected the subsequent clinical outcome recovery. Ongoing follow-up will attempt to recover additional outcomes, at which time definitive study interpretations will become available. Ann’s NOTE: Dr. Kent Osborne stood up and stated that the results were astounding Vis hormone negative patients. I asked Dr. Chlebowski if they had looked at transfats (aka hydrogenated or partially hydrogenated oils - known to be unhealthy), or omega-3 essential fatty acids (known to be healthy). His answer was perplexing – he suggested they only looked at fat in the diet! The summary above does not specify the actual number for OVERALL survival (my emphasis in each case) but my notes indicate 22% fewer deaths with 11% absolute difference in mortality. Mature analysis from women's intervention nutrition study (WINS) Abstract #32 SABCS, 12/06 Homocysteine and breast cancer Abstract #1014 SABCS, 12/06 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.